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    This invoice from Mobile Health Medical Services provides details of no-show fees for 5 patients who missed appointments. It lists the patient names, dates of missed appointments, and $15 or $10 fee for each no-show. The total amount due within 30 days is $70.

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    This invoice from Mobile Health Medical Services provides details of no-show fees for 5 patients who missed appointments. It lists the patient names, dates of missed appointments, and $15 or $10 fee for each no-show. The total amount due within 30 days is $70.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    13 views1 page

    Emai Attachment

    Uploaded by

    shakilshaon13
    This invoice from Mobile Health Medical Services provides details of no-show fees for 5 patients who missed appointments. It lists the patient names, dates of missed appointments, and $15 or $10 fee for each no-show. The total amount due within 30 days is $70.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    229 West 36th Street, 10th floor • New York, NY 10018

    (212) 695-5122 / Fax (212) 695-2260


    www.mobilehealth.com

    Invoice

    Invoice No: 6003654


    Date: 06/30/23
    6520 - Quality Healthcare Resources (QHCR)
    622 3rd Ave 7th Fl A/R Terms: 30
    New York, NY 10017

    Exam No. Patient Name SSN Service(s) Provided Service Date Memo Fee
    23-073931 Tejeda, Destiny XXX-XX-8483 Network Location No Show 05/30/23 $15.00
    Fee
    23-076147 Boulin, Francesca XXX-XX-1139 Network Location No Show 06/02/23 $15.00
    Fee
    23-076830 Camacho, Amarilys XXX-XX-3152 Network Location No Show 06/02/23 $15.00
    Fee
    23-077854 Boulin, Francesca XXX-XX-1139 Network Location No Show 06/07/23 $15.00
    Fee
    23-085824 Harrison, Marquis XXX-XX-6858 Individual Appointment No 06/21/23 $10.00
    Show Fee

    Net Amount: $70.00

    Please make your check payable to: "Mobile Health Medical Services, PC and remit to PO Box 980,
    New York, NY 10008-0980"
    Print Date & Time: 6/30/2023 2:00:11 PM Page 1 of 1

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